Effectiveness of spray application of ACNU in the local control of malignant gliomas: Report of two cases

Malignant gliomas encompassing the eloquent areas cannot be removed totally and their surgical extirpation is followed by adjuvant therapy for the res idual tumor. Recently, we have employed fibrin glue as a vehicle for the su stained release of ACNU (nimustine hydrochloride) by spray application foll owing subtotal tumor removal in two patients with recurrent malignant gliom as. Follow-up MRI at six months demonstrated no neuroradiological evidence of tumor recurrence in the site of operation. We conclude, this novel mode of intra-operative local chemotherapy by spray application of fibrin glue c ontaining antineoplastic agent is effective in the control of residual tumo r progression and may also prevent local recurrence and hence suggests its possible role as an adjuvant therapy in the management of malignant gliomas .